mother/baby chapter 37

The nurse is talking to the parent of a 13-month-old child. The mother states, "My child does not make noises like 'da' or 'na' like my sister's baby, who is only 9 months old." Which statement by the nurse would be most appropriate to make?

"I am going to request a referral to a hearing specialist."

A nurse is providing a parent information regarding autism. Which statement made by the parent indicates understanding of the teaching?

"The onset of autism usually occurs before 3 years of age."

Which statement by a parent about a child's conjunctivitis indicates that further teaching is needed?

"When the eye drainage improves, we'll stop giving the antibiotic ointment."

A nurse is preparing to perform a dressing change on a 6-year-old child with mild cognitive impairment (CI) who sustained a minor burn. Which strategy should the nurse use to prepare the child for this procedure?

Demonstrate a dressing change on a doll.

A newborn assessment shows separated sagittal suture, oblique palpebral fissures, depressed nasal bridge, protruding tongue, and transverse palmar creases. These findings are most suggestive of:

Down syndrome.

Which action is contraindicated when a child with Down syndrome is hospitalized?

Encourage parents to leave the child alone for extended periods of time.

A nurse would suspect possible visual impairment in a child who displays:

Excessive rubbing of the eyes.

Parents have learned that their 6-year-old child has autism. The nurse may help the parents to cope by explaining that the child may:

Have an extremely developed skill in a particular area.

Which assessment findings indicate to the nurse a child has Down syndrome (select all that apply)?

High-arched, narrow palate Protruding tongue Transverse palmar crease

The nurse is discussing sexuality with the parents of an adolescent girl with moderate cognitive impairment. Which should the nurse consider when dealing with this issue?

Individuals with cognitive impairment need a well-defined, concrete code of sexual conduct.

A 2-year-old girl has excessive tearing and corneal haziness. The nurse knows that these symptoms may indicate:

Infantile glaucoma.

A father calls the emergency department nurse saying that his daughter's eyes burn after getting some dishwasher detergent in them. The nurse recommends that the child be seen in the emergency department or by an ophthalmologist. What should the nurse recommend before the child is transported?

Irrigate eyes copiously with tap water for 20 minutes.

Which interventions should the nurse plan when caring for a child with a visual impairment (select all that apply)?

Keep items in the room in the same location. Describe the placement of the eating utensils on the meal tray. Identify noises for the child.

Autism is a complex developmental disorder. The diagnostic criteria for autism include delayed or abnormal functioning in which area(s) with onset before age 3 years (select all that apply)?

Language as used in social communication Symbolic or imaginative play Social interaction

A child with autism spectrum disorder (ASD) is admitted to the hospital with pneumonia. The nurse should plan which priority intervention when caring for the child?

Maintain a structured routine and keep stimulation to a minimum.

A parent whose child has been diagnosed with a cognitive deficit should be counseled that intellectual impairment:

May be caused by a variety of factors.

A young child who has an IQ of 45 would be described as:

Moderately cognitively impaired but trainable.

An adolescent male visits his primary care provider complaining of difficulty with his vision. the adolescent states, "I am having difficulty seeing distant objects; they are less clear than things that are close." What disorder does the nurse suspect the adolescent has?

Myopia

An adolescent gets hit in the eye during a fight. The school nurse, using a flashlight, notes the presence of gross hyphema (hemorrhage into anterior chamber). The nurse should:

Notify parents that adolescent needs to see an ophthalmologist.

Appropriate interventions to facilitate socialization of the cognitively impaired child include to:

Provide peer experiences such as Special Olympics when older.

An appropriate nursing diagnosis for a child with a cognitive dysfunction who has a limited ability to anticipate danger is:

Risk for Injury.

The major consideration when selecting toys for a child who is cognitively impaired is:

Safety

Distortion of sound and problems in discrimination are characteristic of which type of hearing loss?

Sensorineural

A nurse is instructing a nursing assistant on techniques to facilitate lipreading with a hearing-impaired child who lip-reads. Which techniques should the nurse include (select all that apply)?

Speak at eye level. Use facial expressions while speaking. Keep sentences short.

Which action best facilitates lipreading by the hearing-impaired child?

Speaking at an even rate

The nurse is talking with a 10-year-old boy who wears bilateral hearing aids. The left hearing aid is making an annoying whistling sound that the child cannot hear. The most appropriate nursing action is to:

Suggest that he reinsert the hearing aid.

A parent asks the nurse why a developmental assessment is being conducted for a child during a routine well-child visit. The nurse answers based on the knowledge that routine developmental assessments during well-child visits are:

The best method for early detection of cognitive disorders.

What should the nurse keep in mind when planning to communicate with a child who has autism?

The child may exhibit monotone speech and echolalia.

The pediatric nurse understands that fragile X syndrome is:

The second most common genetic cause of cognitive impairment.

Which teaching guideline helps prevent eye injuries during sports and play activities?

Wear eye protection when participating in high-risk sports such as paintball.

The most common clinical manifestation of retinoblastoma is:

White eye reflex.

A child with autism is hospitalized with asthma. The nurse should plan care so that the

Child's routine habits and preferences are maintained.

Mark, a 9-year-old with Down syndrome, is mainstreamed into a regular third-grade class for part of the school day. His mother asks the school nurse about programs such as Cub Scouts that he might join. The nurse's recommendation should be based on knowing that:

Children with Down syndrome have the same need for socialization as other children.

A nurse is preparing a teaching session for parents on prevention of childhood hearing loss. The nurse should include that the most common cause of hearing impairment in children is:

Chronic otitis media.

An implanted ear prosthesis for children with sensorineural hearing loss is a(n):

Cochlear implant.

The most common type of hearing loss, which results from interference of transmission of sound to the middle ear, is called:

Conductive

When caring for a newborn with Down syndrome, the nurse should be aware that the most common congenital anomaly associated with Down syndrome is:

Congenital heart disease.

The teaching plan for the parents of a 3-year-old child with amblyopia ("lazy eye") should include what instruction?

Cover the "good" eye completely with a patch.

A 10-year-old patient is talking to the nurse about wanting to try contact lenses instead of wearing glasses. She states that the other children at her school call her "four-eyes." Contact lenses should be prescribed for a child who is:

Able to independently care for the lenses in a responsible manner.

When a child with mild cognitive impairment reaches the end of adolescence, what characteristic would be expected?

Achieves a mental age of 8 to 12 years

The school nurse is caring for a child with a penetrating eye injury. Emergency treatment includes:

Applying a Fox shield to the affected eye and any type of patch to the other eye.

When should children with cognitive impairment be referred for stimulation and educational programs?

As young as possible

The child with Down syndrome should be evaluated for what characteristic before participating in some sports?

Atlantoaxial instability

Prevention of hearing impairment in children is a major goal for the nurse. This can be achieved through:

Being involved in immunization clinics for children.

Which term refers to opacity of the crystalline lens that prevents light rays from entering the eye and refracting on the retina?

Cataract